Tyson Savage1, Marshall Ross2. 1. Department of Emergency Medicine, University of Calgary, 2nd Floor Foothills Medical Centre, 1403 29th Street, NW, Calgary AB, T2N 2T9, Canada. tyson.savage@ucalgary.ca. 2. Department of Emergency Medicine, University of Calgary, 2nd Floor Foothills Medical Centre, 1403 29th Street, NW, Calgary AB, T2N 2T9, Canada.
Abstract
OBJECTIVES: The primary objective of this study is to identify emergency physician reported barriers to initiating patients on buprenorphine/naloxone in the emergency department (ED) for treatment of opioid use disorder. Secondary objectives include (1) physician reported attitudes about initiating buprenorphine/naloxone in the ED, and (2) comparison of barriers reported based on urban versus rural practice setting. METHODS: An online survey was distributed to a convenience sample of attending emergency physicians and resident physicians using the Canadian Association of Emergency Physicians (CAEP) research survey email distribution network. RESULTS: The survey was sent to 1299 email accounts registered with the CAEP research survey network. We received 121 responses, which is a response rate of 9.3%. The completion rate was 118/121 (97.5%). Most respondents 113/118 (95.7%) reported at least one barrier that prevents them from initiating buprenorphine/naloxone in the ED. The top three reported barriers were (1) lack of allied health care staff who were trained to assist in starting patients on buprenorphine/naloxone in the ED and to help arrange follow-up, (2) time constraints related to patient education on the appropriate and safe use of buprenorphine/naloxone, and (3) access to follow-up resources. The majority of respondents agreed buprenorphine/naloxone was an evidence-based treatment for opioid use disorder and that it is important to make changes in their ED to better facilitate this practice. There was no statistically significant difference in the number of physicians reporting each barrier based on urban versus rural practice setting. CONCLUSIONS: In this convenience sample of physicians working in urban and rural Canadian emergency departments, most physicians perceive barriers that inhibit their ability to initiate buprenorphine/naloxone for patients with opioid use disorder, but overall there is support for making changes to better facilitate this practice.
OBJECTIVES: The primary objective of this study is to identify emergency physician reported barriers to initiating patients on buprenorphine/naloxone in the emergency department (ED) for treatment of opioid use disorder. Secondary objectives include (1) physician reported attitudes about initiating buprenorphine/naloxone in the ED, and (2) comparison of barriers reported based on urban versus rural practice setting. METHODS: An online survey was distributed to a convenience sample of attending emergency physicians and resident physicians using the Canadian Association of Emergency Physicians (CAEP) research survey email distribution network. RESULTS: The survey was sent to 1299 email accounts registered with the CAEP research survey network. We received 121 responses, which is a response rate of 9.3%. The completion rate was 118/121 (97.5%). Most respondents 113/118 (95.7%) reported at least one barrier that prevents them from initiating buprenorphine/naloxone in the ED. The top three reported barriers were (1) lack of allied health care staff who were trained to assist in starting patients on buprenorphine/naloxone in the ED and to help arrange follow-up, (2) time constraints related to patient education on the appropriate and safe use of buprenorphine/naloxone, and (3) access to follow-up resources. The majority of respondents agreed buprenorphine/naloxone was an evidence-based treatment for opioid use disorder and that it is important to make changes in their ED to better facilitate this practice. There was no statistically significant difference in the number of physicians reporting each barrier based on urban versus rural practice setting. CONCLUSIONS: In this convenience sample of physicians working in urban and rural Canadian emergency departments, most physicians perceive barriers that inhibit their ability to initiate buprenorphine/naloxone for patients with opioid use disorder, but overall there is support for making changes to better facilitate this practice.
Authors: Margaret Lowenstein; Austin Kilaru; Jeanmarie Perrone; Jessica Hemmons; Dina Abdel-Rahman; Zachary F Meisel; M Kit Delgado Journal: Am J Emerg Med Date: 2019-02-18 Impact factor: 2.469
Authors: Marc R Larochelle; Dana Bernson; Thomas Land; Thomas J Stopka; Na Wang; Ziming Xuan; Sarah M Bagley; Jane M Liebschutz; Alexander Y Walley Journal: Ann Intern Med Date: 2018-06-19 Impact factor: 25.391
Authors: Gail D'Onofrio; Patrick G O'Connor; Michael V Pantalon; Marek C Chawarski; Susan H Busch; Patricia H Owens; Steven L Bernstein; David A Fiellin Journal: JAMA Date: 2015-04-28 Impact factor: 56.272
Authors: Kathryn A Dong; Karine J Lavergne; Ginetta Salvalaggio; Savannah M Weber; Cindy Jiaxin Xue; Andrew Kestler; Janusz Kaczorowski; Aaron M Orkin; Arlanna Pugh; Elaine Hyshka Journal: J Am Coll Emerg Physicians Open Date: 2021-04-29
Authors: Kathryn F Hawk; Gail D'Onofrio; Marek C Chawarski; Patrick G O'Connor; Ethan Cowan; Michael S Lyons; Lynne Richardson; Richard E Rothman; Lauren K Whiteside; Patricia H Owens; Shara H Martel; Edouard Coupet; Michael Pantalon; Leslie Curry; David A Fiellin; E Jennifer Edelman Journal: JAMA Netw Open Date: 2020-05-01
Authors: Dana D Im; Anita Chary; Anna L Condella; Hurnan Vongsachang; Lucas C Carlson; Lara Vogel; Alister Martin; Nathan Kunzler; Scott G Weiner; Margaret Samuels-Kalow Journal: West J Emerg Med Date: 2020-02-21